NACDS RxIMPACT Advocacy Day

By: Carmela Guangorena Severin, 2018 WSU Doctor of Pharmacy graduate

Wearing a white pharmacist’s coat in the congressional buildings of our nation’s capital gets one a lot of attention. As I rushed from meeting to meeting as a member of Washington state’s advocacy team, I could feel the buzz that our presence generated.

I had the opportunity to participate in RxIMPACT Day this last March. This annual event is sponsored by the National Association of Chain Drug Stores (NACDS), and provides the opportunity for student pharmacists to share critical patient access issues with our legislative representatives. This was the 10th anniversary of the NACDS day of advocacy, and we once again took a stand for better health care by advocating for our profession in Washington, D.C.

Our day on Capitol Hill started with a breakfast briefing, where we reviewed the issues we would discuss and received some tips for how to make the most of a short meeting with a busy legislative representative and/or their staff. We got to know our regional team members, developed our strategy with the guidance of an experienced team leader, and then headed to the heart of our democratic process.

My team of student pharmacists and leaders from Washington state met with seven offices of our state’s congressional representatives including Washington’s newest congresswoman, Rep. Pramila Jayapal of the 7th District. We also met with the staff of Sen. Maria Cantwell, Rep. Dennis Heck of the 10th District, Rep. Rick Larsen of the 2nd District, and Rep. Suzan DelBene of the 1st District, who herself attended part of our meeting with her staff. I must admit, I’m a supporter of Sen. Patty Murray and was most thrilled to shake her hand and receive her support after so many years of pride in being represented by her.

We asked for support on four main bills or congressional letters:

1. Pharmacist provider status with H.R. 592/S. 109, the Pharmacy and Medically Underserved Areas Enhancement Act to provide access for Medicare Part B beneficiaries to receive covered services from pharmacist care-providers.
2. Four proposals to address the nationwide opioid abuse crisis:
   1. A proposal supporting H.R. 3528/S. 2460, the Every Prescription Conveyed Securely Act, requiring electronic prescribing of all controlled substances, computer-to-computer rather than on paper.
   2. A proposal setting a seven-day supply limit for the first prescription of an opioid medication when a patient is inexperienced with the medication for the documented diagnosis. This was also an ask for clarity on Drug Enforcement Administration laws which, in their current verbiage, restrict pharmacists from filling a partial supply even when required by payers or local law.
   3. A proposal creating a national prescription drug monitoring program (PDMP) so that a pharmacist in any state can access all of a patient’s recent controlled substance records regardless of the prescriber, pharmacy, or state in which they’ve received these medications.
   4. A proposal establishing a manufacturer-funded mail-back opioid envelope program to facilitate patients sending unused, potentially hazardous narcotics back to the company for safe destruction without passing the burden of cost and liability to the patient or the pharmacy.
3. A congressional letter to the Secretary of Health and Human Services requesting reform for Medicare Part D direct and indirect remuneration (DIR) fees which are increasingly opaque, unpredictable, and often revoked from the pharmacy months or sometimes years after the medication has been dispensed and the reimbursement amount has been agreed upon.
4. The creation of a working group by the Department of Defense as urged by a congressional letter to the Defense Secretary to improve access to pharmacy services for TRICARE beneficiaries who are currently restricted to receiving their prescriptions only from a military treatment facility or mail-order pharmacy, or paying extra out-of-pocket costs at their local community pharmacy.

This year’s RxIMPACT Day in Washington, D.C., was my first time advocating for my profession at a national level, and it was one of the most important activities of my career thus far. It’s crucial for students to participate in pharmacy advocacy, on both a local and national level, because we are the future of health care in this nation and we are eagerly passionate to leverage the extensive patient-care skills we’ve spent years developing. It may seem intimidating to enter the offices of such important elected members of our government, but their role is to serve us. As much as it is our responsibility to advocate for our patients’ health on an individual level, it is our duty to advocate for the future of our profession and our ability to provide safe, convenient and affordable care.

For pharmacists and students who wish to get involved, connect with NACDS, talk to your school or employer about advocacy opportunities, and make sure to pay close attention to local advocacy efforts, elections, and legislation. More white coats at the Capitol equals stronger representation for our profession and better access for our patients.